The present invention relates to a therapeutically and diagnostically useful method and articles for enhancing, through simple pleasurable activity, mental well-being of dementia patients and other people suffering substantial cognitive and/or physical impairment.
Progressive improvement in physical health in most populations of the world, most markedly in economically advanced countries, has led to a great increase in average human longevity. Unfortunately as people live longer they become more likely to suffer from various forms of neurodegenerative disease or dementia, including senile and presenile dementias and Alzheimer""s disease. Furthermore, people can live with such disorders for long periods of time, often for many years, with only slow progression of the symptoms. Thus improving quality of life of dementia patients is becoming an ever greater need in modem societies.
A problem, particularly in advanced stages of dementia, is that sufferers can become unresponsive to attempts to communicate or interact with them. At the same time, they have in most cases lost the mental acuity to amuse themselves in essentially solitary pursuits that they may have previously enjoyed, such as reading, solving crossword puzzles, assembling jigsaw puzzles or playing games of solitaire. Simple children""s toys such as building blocks can sometimes provide entertainment but are usually not well adapted to the particular needs of people whose mental and sensory faculties are in decline rather than in development.
There exists, therefore, a strong need for a way of entertaining and providing an activity focus to dementia patients, that is appropriate both for patients being individually cared for by relatives and for patients in residential or day-care facilities such as nursing homes, geriatric and psychiatric hospitals, etc.
The present invention derives in part from an observation that in progressive dementias, patients often exhibit more pleasurable responses to stimulation of the sense of touch than to stimulation of other senses, including sight and hearing. In addition, many such patients have significantly impaired senses of sight and/or hearing without major loss of the sense of touch.
The present invention is, in one embodiment, a method of providing mental stimulus to a subject suffering significant cognitive and/or sensory deterioration, the method taking advantage in a new and useful way of the relatively unimpaired sense of touch of such a subject, and thereby enhancing the subject""s psychological condition.
The method of the invention comprises causing the subject to handle an article comprising a plurality of pieces that (a) individually have a surface layer formed of a soft fabric, and (b) collectively exhibit differing tactility when handled by the subject.
A xe2x80x9csubject suffering significant cognitive and/or sensory deteriorationxe2x80x9d herein can be a person having a medically diagnosed neurodegenerative disease, for example a dementia, especially a progressive dementia such as senile dementia or Alzheimer""s disease; or a person manifesting symptoms of significant impairment of cognitive function, such as memory loss, short attention span, inability to learn new information, inability to interact socially, confusion, loss of verbal communication skills, disintegration of personality, judgment and social graces, etc.; or a person being cared for in a regimen adapted to the needs of a dementia sufferer, for example in a residential facility such as a nursing home, geriatric unit, etc.
The term xe2x80x9carticlexe2x80x9d herein includes both an integral object having the pieces connected together, optionally removably, therein, and a kit comprising separate pieces. The article provided to the subject according to the method of the invention is sometimes referred to herein as an xe2x80x9cactivity aidxe2x80x9d.
Soft fabrics herein illustratively include knitted, woven, piliferous and spongiform textiles and real and simulated furs, skins and leathers.
A piece can be constructed of two or more layers, of which a surface layer is formed of a soft fabric; alternatively a piece can consist essentially of the soft fabric surface layer. If desired, a piece can have two opposing surfaces formed of the same or different soft fabrics.
Pieces described herein as exhibiting xe2x80x9cdiffering tactilityxe2x80x9d are readily distinguishable one from another, and/or have opposing surfaces that are readily distinguishable, by sense of touch alone. The differing tactility can result from the use of soft fabrics that are per se distinguishable by touch, or from other features of the pieces, for example subsurface layers distinguishable by touch through a lightweight surface fabric.
The pieces can be substantially identical in shape and/or construction, or can differ in shape and/or construction from one another, for example constituting two or more sets each comprising one or more substantially identical pieces.
In a presently preferred embodiment, differing tactility is provided at least in part by the soft fabric surface layers. Most preferably, at least one soft fabric used in a surface layer is a piliferous fabric. Without being bound by theory, it is believed that the act of handling a soft piliferous fabric provides particularly pleasurable tactile stimulation for a dementia patient and lends enhanced interest in the activity aid on the part of the patient.
For many subjects, it will be found sufficient to provide the activity aid, and the subject will spontaneously handle the pieces and derive pleasurable tactile stimulation thereby. The term xe2x80x9ccausing the subject to handle . . . xe2x80x9d an article as described herein will be understood to embrace the simple act of providing the activity aid to the subject, even where no further encouragement or assistance is needed to promote handling of the article by the subject. For other subjects, in particular those suffering more advanced stages of neurodegenerative disease, it may be found insufficient merely to provide the activity aid. In such a case, xe2x80x9ccausing the subject to handle . . . xe2x80x9d an article as described herein will typically comprise providing the article to the subject and encouraging and/or assisting the subject to handle the article so as to elicit a tactile stimulus.
In a further embodiment, a kit useful as an activity aid is provided, comprising (a) a plurality of tile elements having one or more faces that are compressively resilient to human touch, wherein each tile element comprises a soft fabric surface layer, a substantially rigid base or core, and a subsurface compressively resilient layer interposed between the surface layer and the base or core; and (b) a rack comprising means for engaging the tile elements at a plurality of loci on the rack, and a rack base whereon the tile elements can rest.
By xe2x80x9ccompressively resilientxe2x80x9d is meant having the properties of (a) being compressible by a light force such as applied, for example, when pressing, stroking, rubbing or squeezing with the fingers, and (b) having a bias to return to an original conformation upon removal of the force. By contrast, the term xe2x80x9crigidxe2x80x9d, as applied to a base or core of a tile element, means non-compressible and/or non-resilient.
The compressively resilient quality of a tile element according to the present embodiment can reside at least in part in a material of which the subsurface layer is substantially composed, provided the tile element has a surface layer of sufficient flexibility to transmit a light force, such as applied by a finger, to and from the subsurface layer. Examples of such subsurface layers include without limitation paddings (including battings, waddings and stuffings) and cells and cavities filled with air, liquid, gel or solid grains (including beans, rice grains, polystyrene prills and the like). Other suitable compressively resilient materials include without limitation natural and synthetic sponges, solidified foams, cork, rubber and certain soft plastics.
Alternatively or in addition, the compressively resilient quality of a tile element according to the present embodiment can reside at least in part in the soft fabric surface layer of the tile element. Soft fabrics herein illustratively include knitted, woven and piliferous textiles and real and simulated furs, skins and leathers.
The tile elements of any one kit according to the present embodiment can be substantially identical in shape and/or construction, or can differ in shape and/or construction from one another, for example constituting two or more sets each comprising one or more substantially identical tile elements. It is preferred that the soft fabric forming the surface layer of at least one set, and optionally of all sets, of tile elements be a piliferous fabric.
While the kit according to the present embodiment is primarily intended for use by subjects having a medically diagnosed neurodegenerative disease, in particular a dementia, the kit can also have utility as a toy, for example for very young children or for older children having learning or developmental difficulties, as a recreation for blind and partially sighted persons, and for other purposes.
According to the method of the invention, an activity aid as described herein can be used by a single subject, or by two or more subjects together, for example as a simple assembly or construction pastime, a puzzle or a game. From the detailed description below of illustrative embodiments, it will become clear how these and other modes of use are enabled by the present invention.
The method of the invention has therapeutic benefit to a cognitively impaired subject in one or more of the following respects:
(a) it relieves emotional distress or anxiety;
(b) it lends a sense of purpose;
(c) it provides a challenge appropriate to the patient""s mental acuity;
(d) it provides a sense of achievement;
(e) it is a simulated xe2x80x9cworkxe2x80x9d activity;
(f) it exercises hand and eye coordination;
(g) it provides tactile feedback where other senses are impaired;
(h) it relaxes, calms or soothes the patient;
(i) it provides a focus of attention;
(j) it encourages interaction between the patient and others;
(k) it can provide solitary entertainment;
(l) it can reduce isolation;
(m) it gives a feeling of greater independence;
(n) it is self-pacing;
(o) it can provide structured or unstructured activity;
(p) it can introduce an element of healthy competition;
(q) it provides a vehicle for communication where sight and/or hearing is lost;
(r) it promotes contentment, happiness and psychological comfort;
(s) it promotes a feeling of connectedness with the subject""s environment.
Providing an activity aid to a cognitively impaired subject according to the invention is useful in promoting interaction between the patient and caregivers, visiting relatives and friends, other patients, etc., especially where the patient has substantially lost the faculty of verbal communication.
The method of the invention is also useful diagnostically, for example in assessment of the degree of cognitive impairment in a subject using the activity aid.
In a preferred activity aid, the pieces are soft on all sides and have no sharp edges or corners; in addition they are too large to be swallowed. Such an activity aid therefore poses minimal risk of injury to a patient using the activity aid or to other people in the vicinity.